D. E. Larsen, DVM
The ground was frozen solid, and I stumbled as I traveled over the uneven mud headed to the small barn. I was carrying my medical bag and a bucket of warm water, and I hoped I wouldn’t slush most of the water before making it to the barn.
Jan was leading the way with a flashlight that cast a dim beam. I hoped the batteries would last till we got to the barn and I could get my lantern out of my bag.
Inside the barn, it was just as cold as the outside, and there were no lights. The little calf was laid out in a thick bed of straw. I dropped to my knees and opened my bag. Turning on the lantern helped light up this corner of the barn.
The calf’s muzzle was cold, and I stuck a finger in his mouth, and he had only a weak suck reflex.
“You said this calf was normal this morning?” I asked.
“Yes, he was bouncing around like all the other calves,” Jan said. “I was surprised when I came out this evening and found him stretched out like he was dead. I’m sorry I called so late, but we were gone this afternoon, and I didn’t get out to check on things until after dark. I could have missed him altogether if I hadn’t almost tripped over him.”
“You should convince Frank that you should put lights out here,” I said. “Even a battery-operated lantern like this one would help.”
“What do you think about the calf?” Jan asked.
“He has some diarrhea, but for that to cause this kind of collapse in twelve hours would be unusual,” I said. “He would have been dead in the morning if you hadn’t found him, and I’m not sure we can save him. This weather is pretty rough. Do you have any place you could put him where it would be warmer?”
“The garage is just as cold as the barn,” Jan said. “I don’t think enough of him to bring him into the house. He is going to have to make it here. This bed of straw is the best I can do. I guess we could see if we have an extension cord long enough so we could hang a heat lamp for him.”
“I am going give him some oral fluids that will put a warm spot in his belly,” I said. “And I will give him a big dose of IV antibiotics. If he is dead in the morning, we should send some samples to the lab. If you have a hot bug on the place, we need to know about it. We don’t want any others to show up like this one.”
***
“Jan is on the phone,” Sandy said. “That calf you treated last night is dead this morning.”
“You need to free some time up for me to run out this morning to do a necropsy on that calf,” I said.
“She was hoping she could bring it into the clinic,” Sandy said. “Just to avoid paying for another farm call.”
“Tell her I will run out there for no farm call charge,” I said. “If there is a hot E. coli in that calf, we don’t need to contaminate the clinic.”
I checked to ensure I had everything I might need in the truck. I thought I would need several samples from the calf, to include fresh samples for culture and samples in formalin. When everything was loaded, I headed out to meet with Jan.
“I don’t know when he died,” Jan said. “He was cold and stiff this morning.”
“That doesn’t surprise me,” I said. “I think he was pretty close to being gone when we treated him last night.”
“I know you are worried that there was something important that caused his sudden death,” Jan said. “But we are a little concerned about the expense of a lot of lab work.”
“I can understand that,” I said. “And it is a valid concern if we send samples to the lab with a blank check. But we can hold them to some specific tests. But let me get a look first, and there might be an easy explanation.”
I opened his abdomen from his chest to his pelvis with the calf on his back.
“What the heck is this?” I said, more to myself than to Jan. “His small intestine is ruptured.”
There was intestinal content all through his abdomen. There would have been no saving this fellow. I searched through the intestines until I found the transected loop of the bowel.
“What could have caused that to happen?” Jan asked as she watched over my shoulder.
“That’s a good question,” I said as I continued to explore the abdomen. “It looks like it was strangulated. I guess I better check his belly button.”
When I looked at his umbilicus, there was a large hernia present, and there was no content in the hernia.
“It looks like he had a large umbilical hernia,” I said. “Apparently, a loop of bowel got in there and strangulated. The bowel must have returned to the abdomen when it ruptured, so it wasn’t obvious when I treated him last night. Not that it would have made any difference, there was no saving him, probably not even with a heroic surgery.”
“So, are you still going to need to send stuff to the lab?” Jan asked.
“No, this was just one of those things, sort of the luck of the draw,” I said. “The interesting thing is we usually don’t worry about umbilical hernias in the calf. But, obviously, they can be a problem if they are large enough.”
“Are these hernias genetic?” Jan asked.
“I don’t know for sure,” I said. “I think they are considered genetic, but probably they don’t have a simple inheritance factor. I never see enough of them to worry much about them. When I was in Enumclaw, another veterinarian in the practice bought a bunch of heifer calves to raise. We repaired several hernias in that bunch. After we did that, those calves seemed to do a lot better. We wondered after that event if we should be putting more emphasis on repairing umbilical hernias in calves. This guy would support that opinion also.”
Photo by Diego F. Parra from Pexels
Fascinating. NIce to meet a doctor (vet) in this case who has been sympathetic to the cost of things.
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If the vets are out in rural areas and treat many cattle, they usually answer to the needs of their clients. And their clients are the owners, not the calves and cows … No use selling a milking machine to a farmer with one cow and taking the cow as payment … that farmer would not be your client much longer.
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Very good analogy, Fran. I will have to remember that one.
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Thanks for your comment, Pat. In food animal medicine the vet is also a business advisor to the owner/client. I was always taught that what might be the best medical decision is often not the best financial decision.
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Regarding the impact of genetics of health outcomes, I happen to have known a woman who needed repair of an inguinal hernia, right side. Her son also had an inguinal hernia repair, right side. Same goes for three of his children. Anecdotal, but fairly convincing to me. Of course, the older I get the more I observe that genetics play a key role in all kinds of outcomes. Of course, natural selection has been hampered a bit over the past hundred years of so. Perhaps more.
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The book says hernias are heritable but the pathway is complex and probably involves multiple genes.
I also think that most things in our lives are probably etched in our DNA. And man’s meddling in the mix has sure a rich history of accomplishment and unintended consequences.
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A logical approach to treatment and then analyzing cause and affect. Veterinarians have so much more heart and insight to put into that mix, compared to MD’s.
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Thanks for the comment, GP. Veterinarians pretty much had to do everything on their own at the time this event happened. That is maybe less so today. MDs are so specialized today, the primary care folks are reduced to mere gate keepers.
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I have found that MD’s, specialized or not try to fit everyone into common ailments, no investigation would be needed. A veterinarian (or at least those those I’ve dealt with,) do whatever it takes to discover an animals problems.
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